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Mental Health & Depression in Japan | Therapy & Support Guide
Moving to Japan could be one of the most influential decisions you make, exploring sights such as the Saga Prefecture, moving into your own apartment, even re-learning simple tasks such as visiting a convenience store, can all make for wonderful memories in Japan.
There is one thing however that often gets overlooked, and that is mental health. More specifically, coping with mental health in Japan. Whether you’re using a Japanese visa or are in Japan on a working holiday, making the move can be a big step for both you and your mental health.
Mental health, not only in Japan but around the world is something that has finally been given the floor to speak. It is no longer the taboo subject it was years ago, and is now widely accepted with almost endless treatment options and support available.
We understand that mental health is a particularly personal and complex issue and requires the right and support and understanding to make progress. So if you’re living with mental health issues in Japan, whether depression, anxiety or any other condition here is all the information to help find the support you need.
It’s important to establish your boundaries and build those ‘foundations’ as it were.
The Social Stigma Against Mental Health in Japan
Japan has one of the most extensive and efficient health care systems in the world, with medical standards and technology like no other. Unfortunately, mental health for a long time in Japan until only recently was something that was to be looked down upon.
In Japan, the loss of ‘mental self-control’ or mental health conditions such as depression and anxiety were seen as something over which a person is unable to exercise will power. Ingrained in Japanese culture, those who are unable to practice will-power are taught to feel a sense of shame as a result.
The view of mental health in Japan was easily one of society’s biggest problems to overcome as it has been so deeply woven into the culture and standards of everyday life. Essentially, even something as simple as going to therapy or counselling was seen as somewhere where ‘crazy people go’.
How Has Mental Health, Depression and Therapy Changed Over the Years in Japan?
Fortunately, mental health, therapy, psychotherapy in Japan are all much more socially accepted, with even the list of recognised disorders growing all the time. Conditions such as post-traumatic stress disorder (or PTSD), depression, schizophrenia, bipolar, ADHD are all now acknowledged and treated appropriately.
It’s only recently mental health treatment has been given government funding and support in Japan, which while late, can only be seen as a step in the right direction for those living with mental health issues in Japan.
Alongside this, the Japanese government has instituted various mental health policies and laws over the past decade all relevant to mental health. The way in which the government was previously set up regarding mental health needed a major update, so this reform was aimed at removing the stigma behind mental health and improving the overall wellbeing of all residents.
What are the Leading Causes of Anxiety and Depression in Japan?
While for the most part there doesn’t have to be a reason for mental health issues, it can be hereditary, a chemical imbalance etc. there are however some causes that may contribute to this, particularly in Japan.
Here are the leading causes or contributions to mental health in Japan.
Technology
Technology, and thus innovation is deep-rooted into what gives Japan a competitive edge. With world-leading technology in vehicles, consumer electronics, robotics, medical devices, film and much more, that can only be good. Right?
For the most part, technology is revolutionising the way we work, learn, relax and communicate, there’s no argument about that. Mobile phones, laptops, tablets, all have become an irreplaceable asset for everyday life.
Unfortunately, that doesn’t mean that these devices aren’t having a toll on our mental health. With the new generation being born into endless facets of technology, PS5s, Nintendo Switches, iPhones, there is becoming an overcoming reliance on these gadgets.
Technology may well be contributing to an increase in those suffering from anxiety and depression, as technology has become a substitute for human interaction leading to going out and meeting people less.
Culture
The economy in its current climate is very unforgiving on the mental toll that it can take on individuals. Passing interviews, writing cover letters, ultimately the job search in Japan can all be daunting tasks. Luckily there is support from agencies such as ourselves to provide the necessary aid.
The working atmosphere and expectations are a large factor in ongoing mental health problems, contributing to ‘karoshi’ also known as “death from overwork”. There was very much a negative perception of those that take time off, leading to workers taking only 52.4% of the paid leave to which they were entitled in 2018, according to the most recent government figures.
However, this is not an issue that has been swept under the rug, Prime Minister Shinzo Abe, instituted a new bill in 2018 called the ‘Work Style Reform Bill’ in aid to modernise Japan’s working culture. There have been key amendments to eight labour laws, influencing aspects such as flexible working, caps on excessive working hours, and a requirement for employees to take annual leave.
Lack of Resources
While there has been a government initiative to build on mental health advocation and treatment in Japan, there are still areas that are lacking. Rural areas such as Tohoku, towns and villages that aren’t close to big cities are short of the medical professionals and facilities to undertake mental health support and treatment.
This gap is slowly but surely being filled, with mental health being a priority going forward.
Culture Shock
Moving to Japan, it’s a big move. Many people living abroad consider doing so one of the best decisions they’ve ever made, and while others think the same it can also be an especially anxiety-inducing procedure.
This can be anything from adjusting to the new way of living, to being homesick and missing all of the comforts of your home country. Culture shock can contribute to any anxiety or depression you may be feeling, inducing a wave of panic, this is normal.
It’s important to establish your boundaries and build those ‘foundations’ as it were. What’s familiar? What reminds you of home? Is it playing sports? Seeing friends? Or just kicking back and binging on Netflix? Even something like learning Japanese can help you connect with more people.
Moving countries can take its toll on even the best of us, so it’s important to stay in open communication and take pleasure in knowing you’re not alone.
What Options are Available for those Suffering from Mental Health in Japan?
If you are suffering from mental health conditions while living in Japan, there are a vast list of treatments and support available for you. From medication and therapy to self-help, below are the options available for those suffering from mental health in Japan.
Psychotherapy
Psychotherapy, also known as “psychological therapy” or “talking therapy” is a prime option for mental health treatment in Japan.
This type of therapy in Japan is focused on helping a person change their behaviour and overcome problems in a healthy way. This can be used to help treat depression, anxiety, stress, insomnia, addiction, negative behaviour patterns, bipolar, schizophrenia and much more.
There are four types of psychotherapy treatments; cognitive behavioural therapy (CBT), dialectical behaviour therapy, interpersonal therapy and family-focused therapy.
Psychotherapy as opposed to traditional therapy works to create a long-term relationship with clients, digging deeper into behaviour patterns and deep-rooted issues as a means to overcome them.
This form of treatment can usually be covered under health insurance, however, private and other situations may call for more expensive treatment leaving you liable for the cost.
CBT (Cognitive Behavioural Therapy)
Cognitive behavioural therapy (or CBT for short), as mentioned above is a form of psychotherapy. It is a talking form of therapy that looks to help you deal with any overwhelming problems more positively by breaking them down into smaller, more manageable parts.
CBT is largely based on the ideology that your thoughts, feelings, physical sensations are all connected. Meaning that negative thoughts or behaviours can contribute to falling into a cycle, which CBT works to break down.
While CBT was introduced in Japan in the late 1980s, it wasn’t until more recently, in the past decade or so that it has become a core part of mental health offerings in Japan and is covered by the national health insurance scheme.
Antidepressants
Antidepressants are a form of medication used to treat clinical depression and anxiety, to subside some of the side effects of living with such conditions. The most prominent of which is Sertraline and Citalopram, and can help those living with mental health issues in Japan manage everyday life better.
While you can import your medication, as standard you are only allowed to import a month’s supply of prescription medication. You can apply for a Yakkan Shoumei, an inspection certificate approval that essentially works as a means of advanced permission for importing more than the standard quantity of medication.
However, once you have enrolled in Japanese national health insurance, you are then able to collect your medication directly from a hospital or clinic in Japan. And with over 22,000 types of medication available, there’s a very high probability your medication will be available, right here in Japan.
Inochi No Monban (Gatekeeper For Life)
There are, of course, less hard-rooted ‘institutional’ means of support for mental health in Japan. The most well-known is called ‘inochi no monban’ which translates to “gatekeeper for life”.
Inochi no monban are just regular people who have trained to spot suicidal tendencies and severe mental health in social settings. These people will then help you find the support you need.
This program is an initiative led by the local government among other efforts to help fight the age-old stigma against mental health in Japan as well as encouraging people to seek therapy and appropriate treatment.
Exercise
Just as much as therapy and medication can help treat mental health, a healthy body is just as much of a contribution to a healthy mind. Exercise and wellbeing going hand in hand, so whether you’re riding your bicycle, working out in a gym, playing sports, moving your body can help to improve moods, stress levels, anxiety and depression.
The general advice is 2.5 hours of moderate-intensity activity over a week, the equivalent to 30 minutes a day for 5 days a week. While this may seem quite overwhelming this can be as little as going for a jog or a run, for as little as 30 minutes during the week.
In fact, according to Start Active, Stay Active, there is a 20%-30% lower risk of depression and general feelings of distress for adults participating in daily physical activity.
How Much Does Mental Health Treatment Cost?
Mental health treatment is made widely available in Japan, and for the most part, is covered by national health insurance. Meaning that you are only expected to pay 30% of the total cost.
Unfortunately, counselling isn’t so affordable as this isn’t covered by your health insurance. With it costing anywhere between 5,000 and 20,000 yen just for a single session, often lasting no longer than 30 minutes. This equates to anywhere between £33 and £133 for a single half-hour session.
Medication such as antidepressants is more affordable with a single pack costing around 870 yen a month, which equates to roughly £6.
Mental Health, Depression and Therapy in Japan for Foreigners
While mental health treatment in Japan for the most part is quite widely scoped, finding a facility that offers healthcare in foreign languages can be difficult, and one that offers mental health advice and treatment is a much scarcer find.
For example, the Yotsuya Yui Clinic in Shinjuku, Japan offers mental health treatment in multiple languages, English, Spanish, Korean etc. institutions such as this are considerably difficult to come by. Especially since interpreters are usually required, and interpreting services are not covered by national health insurance, leaving independent medical facilities and patients to front these additional costs.
Initiatives like Tell Japan also offer dedicated advice for Japan’s international community.
“TELL is dedicated to providing effective support and counseling services to Japan’s international community and its increasing mental health needs.”
Getting your mental health medication ready in Japan is made much easier if you have your prescription translated to Japanese before your visit. All that is required then is your Japanese National Health Card and a short chat with a psychiatrist at a clinic of your choice – you will then be given the appropriate prescription to take to a pharmacy.
Additional Advice for Treating Mental Health in Japan
Mental health, depression, anxiety and therapy in Japan are all different from what you have come to expect at home. Mental health support and treatment in Japan requires a change in expectations, this is necessary to adjust to the new systems in place in Japan.
Appointments should be made well in advance as many clinics only take on a short number of patients and new ones take even longer to get seen. If you can’t find a clinic near you that you can be seen by or do not feel comfortable in, it may be worth investing in broadening the search and travelling that bit further.
It’s also worth noting that even though mental health isn’t the taboo subject it once was, it’s still best to avoid personal discussions in places of work.
Remember that mental health, in any form, is nothing to be ashamed of. And living in Japan doesn’t change that, admitting you have a problem and asking for help is the first step to getting help. And that is admirable.
Interested in living and working in Japan? Check out ALT jobs with Interac here.
About the Author
Brian McDonough is a consultant at Interac, Japan’s largest provider of ALTs (Assistant Language Teachers). Originally from the US, Brian has lived in Japan for over 25 years, giving him a unique perspective on the cultural differences and challenges people face when moving to Japan. He has first-hand experience of working in Japan as an American.